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  • 1
    In: Perfusion, SAGE Publications, Vol. 20, No. 2 ( 2005-03), p. 71-75
    Abstract: Autotransfusion of the residual blood from the cardio-pulmonary bypass (CPB) circuit is considered to be one of the methods enabling reduction in the need for transfusion, the possible adverse effects of which are well known and documented. The aim of the study was to evaluate the effectiveness of the autologous autotrans-fusion of centrifuged red blood cells from the residual blood of the CPB circuit in patients following heart surgery. Three groups of patients who underwent heart surgery were examined. The first group (Group 1) consisted of 37 patients who received all of the residual blood in the bypass circuit after CPB (collected into sterile plastic bags) during the early postoperative period. The second group (Group 2) consisted of 45 patients who did not receive the residual blood following CPB. The third group (Group 3) consisted of 42 patients who underwent re-infusion of centrifuged red blood cells from the residual blood remaining in the CPB circuit during the early postoperative period. Hematocrit (Hct) values 12 hours after the operation were found to be higher in Group 3 compared with those of the first and the second groups (by 13.2% and 11.1%, respectively). Blood loss during the first 12 hours after the operation and during the time spent in the intensive care unit did not differ between the groups. The number of transfusions was significantly lower in Group 3 (28.57%) in comparison with that of Groups 1 and 2 (37.83% and 38.10%, respectively). The rate of infective complications in Group 3 was lower in comparison with both Group 1 and Group 2 (9.2% and 18.1%, respectively). The duration of in-hospital stay in Group 3 was 25.8% shorter than Group 1. We conclude that autotransfusion of centrifuged red blood cells processed from the residual blood of the CPB circuit after CPB was effective in increasing Hct values 12 hours postoperatively, reducing the need for donor blood product transfusions, the rate of infective complications and lenght of stay in hospital.
    Type of Medium: Online Resource
    ISSN: 0267-6591 , 1477-111X
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2005
    detail.hit.zdb_id: 2029611-3
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  • 2
    Online Resource
    Online Resource
    MDPI AG ; 2008
    In:  Medicina Vol. 44, No. 11 ( 2008-11-12), p. 871-
    In: Medicina, MDPI AG, Vol. 44, No. 11 ( 2008-11-12), p. 871-
    Abstract: Airway obstruction is a quite common complication while its conditioned pulmonary edema – rare. Causes associated with anesthesia are various. Forced inspiratory efforts against an obstructed upper airway generate peak negative intrathoracic pressure. This may cause pulmonary edema and in some cases pulmonary hemorrhage. Last-mentioned is extremely rare. Pulmonary edema may arise soon after airway obstruction as well as later, after some hours. Damage of bronchi is found seldom during bronchoscopy in case of pulmonary hemorrhage, while more often alveolar damage is observed due to alveolar membrane damage. Hemorrhage is conditioned by hydrostatic pressure level, level of hypoxia, damage to bronchi or alveoli (disruption of alveolar membrane). Early diagnosis of negative-pressure pulmonary edema or pulmonary hemorrhage is very important, because this affects postoperative morbidity and mortality of the patients. Two cases of pulmonary edema and hemorrhage after upper airway obstruction as well as literature overview are presented in this article. Pulmonary hemorrhage developed during anesthesia with ketamine, conditioned by increment of hydrostatic pressure, hypoxia, and effects of ketamine on hemodynamics.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    Language: English
    Publisher: MDPI AG
    Publication Date: 2008
    detail.hit.zdb_id: 2088820-X
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  • 3
    In: Perfusion, SAGE Publications, Vol. 22, No. 2 ( 2007-03), p. 121-127
    Abstract: Background. The aim of the study was to evaluate the effect of hypertonic NaCl hydroxyethyl starch solution on haemodynamics and cardiovascular parameters in the early postoperative period in patients for correction of hypovolaemia after heart surgery. Methods. Eighty patients undergoing myocardial revascularisation at the Clinic of Cardiac Surgery of the Heart Centre (Kaunas University of Medicine) were randomly divided into two groups. The HyperHaes ® group (n = 40) received 250 ml 7.2% NaCl/6% HES solution and the control Ringer's acetate group (n = 40) received placebo (500ml Ringer's acetate solution) for volume correction after the surgery. Results. After infusion of HyperHaes ® solution, cardiac index increased from 2.69 (0.7) to 3.52 (0.8)l/min/m 2 , systemic vascular resistance index, pulmonary vascular resistance index and the gradient between central and peripheral temperature decreased, and oxygen transport parameters improved. Ringer's group patients needed more intensive infusion therapy (4050.0 (1102.2) ml in the Ringer's group, 3513.7(762.5) ml in the HyperHaes ® group). During the first 24 hours postoperatively, diuresis was significantly higher in the HyperHaes ® group (3640.0 (1122.9) ml and 2736.0 (900.7) ml), total fluid balance was lower in HyperHaes ® group (1405.6 (1519.0) ml and 2718.3 (1508.0) ml, respectively). After the infusion of HyperHaes ® solution, no adverse events were noted. Conclusions. HyperHaes ® solution had a positive effect on haemodynamic parameters and microcirculation. Oxygen transport was more effective after HyperHaes ® solution infusion. Higher diuresis, lower need for the infusion therapy for the first 24 hours and lower total fluid balance were determined in the HyperHaes ® group. No adverse effects were observed after HyperHaes ® solution infusion. Perfusion (2007) 22, 121—127.
    Type of Medium: Online Resource
    ISSN: 0267-6591 , 1477-111X
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
    detail.hit.zdb_id: 2029611-3
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  • 4
    In: Medicina, MDPI AG, Vol. 48, No. 9 ( 2012-10-05), p. 71-
    Abstract: Objective. The aim of this study was to determine the prevalence of burnout among Lithuanian cardiac surgeons and cardiac anesthesiologists, and associations between burnout and the personal and professional characteristics of physicians. Material and Methods. A total of 29 cardiac surgeons and 30 cardiac anesthesiologists employed in Vilnius and Kaunas university hospitals as well as in Klaipėda Hospital were surveyed. Data on personal characteristics (age, gender, marital status, number of children, sleeping hours, and addictions), professional characteristics (years in practice, work character, work profile, and workload), career satisfaction, and symptoms of depression were collected by using an anonymous questionnaire. Burnout was measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Results. More than half (54.3%) of the physicians surveyed had been in practice for 〉 15 years, 71.2% reported working more than 40 hours per week, and 62% reported of being burned out. As much as 19.3% of physicians reported high emotional exhaustion, 25.9% had high depersonalization, and 42.3% demonstrated low personal accomplishment at work. Nearly 95% of respondents would become a physician and 82.8% would choose to become a cardiac surgeon or a cardiac anesthesiologist again. Physicians who worked more than 40 hours per week, smokers, and those who were desperate were more likely to be burned out. Conclusions. Burnout was found to be prevalent among Lithuanian cardiac surgeons and cardiac anesthesiologists. Some personal and professional characteristics were significantly related to burnout. Burnout relief measures should be developed in order to prevent a further increase of burnout syndrome among Lithuanian cardiac surgeons and cardiac anesthesiologists.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    Language: English
    Publisher: MDPI AG
    Publication Date: 2012
    detail.hit.zdb_id: 2088820-X
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  • 5
    In: Journal of Clinical Anesthesia, Elsevier BV, Vol. 21, No. 7 ( 2009-11), p. 474-481
    Type of Medium: Online Resource
    ISSN: 0952-8180
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2009
    detail.hit.zdb_id: 1500489-2
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